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MC-19-2138Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date: 02/06/2020 Location Address Parcel Number 38 NE 110TH ST, Miami Shores, FL 33161 1121360040350 Contacts Permit NO.: MC-09-19-2138 Permit Type: Mechanical - Residential Work Classification: Pool Heater Permit Status: Approved Expiration: 08/04/2020 ROCCO AND JESSICA RIGGIO Owner HAVANA AIR CONDITIONING, INC Contractor 38 NE 110 ST, MIAMI SHORES, FL 33161 OSVALDO BORRELL Other: 3055345051 887 W 34 ST, HIALEAH, FL 33012 Business: 3055589136 11 Description: NEW POOL &DECK HEATER Valuation: $ 3,000.00 Inspection Requests: 305-762-4949 TotalSq Feet: 498.00 Fees Amount Application Fee - Other $50.00 CCF $1.80 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.60 Permit Fee $50.00 Scanning Fee $3.00 Technology Fee $2.50 Total: $111.90 Payments Date Paid Amt Paid Total Fees $111.90 Credit Card 09/16/2019 $50.00 Credit Card 02/06/2020 $61.90 Amount Due: $0.00 Building Department Copy In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I oriz he; named co �tor to dolge wo stated. Authorized Signature: Owner / Applica / ontractor Date February 06, 2020 Page 2 of 2 ,Miami Shores Villag.. Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION ❑ BUILDING ❑ ELECTRIC ❑ ROOFING P`_CEIVED SEP 16 2019 'O.— (Pk4/*1 FBC 201-D' Master Permit No. A ' Sub Permit No. 1"' C— ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING MECHANICAL ❑PUBLICWORKS ❑ CHANGE OF [:]CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: ,�l Ac I I O City: Miami Shores County: Miami Dade Zip: 361u l Folio/Parcel#: It'al 75(.0'QQ+- 0350 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder):Ali f[ � ICXQI© Phone#: 19(P-?��� Address: -31 NIP,c • lid zl. City: Kan State: TE, Zip: 3 I,IQ I Tenant/Lessee Name: i A/JfT Phone#: Email: r"/jr ` CONTRACTOR: Company Name: i9�,►J-1�� 4ei-0014 %�M /Nj ZLe_. Phone*,5 f ' 13,6 0 Address: d � W" r— City:tlijGD-4 State: /E'L Zip: A•31���- Qualifier Name: 09.5y '—A 0-04"C-e- Phone#: �3Or State Certification or Registration #.' C,4 Ga ✓5' 3 Certificate of Competency #: DESIGNER: Architect/Engi G Phone#: 30� .2 6�-•�D� 2 Address: 445r City: M M A i State: X_ Zip: 3. Value of Work for is Per $ Type of Work: Add1-0 i Alteration Description of Work: Specify color of color thru tile: Submittal Fee $ &v Permit Fee $ Scanning Fee $ Technology Fee $, Structural Reviews S (Revised02/24/2014) Radon Fee $ _ Square/Linear Footage of Work: New ❑ Repair/Replace Training/Education Fee $ ❑ Demolition CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ Cd I !�j d r, Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING-'TO`OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. : IF' YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value. exceeding, $2500,,the applicant must promise in good faith that, a copy of the notice of commencement and construction lien law brochure will be delivered;to the: person whose property is subject'to attachment. Also, a certified copy of the 'recorded notice of commencement must be posted'af'th' job site for the first inspection which occurs seven (7) days after the building"permit is issued. In the absence of such posted notice, the inspection will not be approved rd a reinspection fee will be charged. Signature Signature OWNER or AGENT The foregoing instrument was acknowledged before me this n,�,�66ncll�, /day of = G�J I 20 /� by K Y�iCkGi IQ who ' personally known to me or who has produced as identification and who did take an oatw. NOTARY PUBLIC: Sign: � Print: cL y;kC.- Seal: Notary Public - State of Florida Commission # GG 250751 My Comm. Expires Feb 14, 2021 CONTRACTOR The foregoing instrument was acknowledged before rma this � day of 20 V'/ by who �.is((((personally known to rrr wh o has produced VJQ .Q- J as identification and who did take ari oath. NOTARY PUBLIC: 0 Sign' Print: Seal: Notary Public - State of Florida Commission .k GG 250751 My Comm. Expires Feb 14, 2021 *****************************APPROVED***** **** **************************************************************** BY lans Examiner Zoning Structural Review Clerk (Revised02/24/2014)